2型糖尿病患者对心血管药物的坚持模式:使用初级保健中基于小组的轨迹分析进行的回顾性队列研究
Sri Chodapuneedi1, Jia Wei Koh2, Zhomart Orman1
1School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Diabetes research and clinical practice
|August 7, 2025
概括
超过一半的2型糖尿病患者表现出不持久的药物坚持,在五年内逐渐下降或早期停止药物的明显模式. 识别预测因素对于定制干预措施来改善坚持至关重要.
科学领域:
- 内分泌学和新陈代谢学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 2型糖尿病 (T2DM) 管理需要长期坚持服用降血糖,降血脂和降血压药物.
- 不坚持治疗对实现治疗目标和预防T2DM并发症构成重大挑战.
- 了解长期坚持模式及其预测因素对于优化患者的治疗结果至关重要.
研究的目的:
- 评估T2DM患者的长期药物坚持模式.
- 识别与非持久的坚持行为相关的预测因素.
- 为持续的治疗坚持提供信息,制定针对性的干预措施.
主要方法:
- 使用2013-2023年初级保健数据进行的回顾性队列研究.
- 在60个月内评估的药物坚持,定义为每六个月接受一次处方.
- 基于组的轨迹分析 (GBTA) 确定了坚持模式;多项逻辑回归探索了预测因素.
主要成果:
- 观察到三种坚持轨迹:持续坚持 (40.6%-44.3%),逐渐下降 (32.7%-36.6%),以及早期停止 (21.0%-26.7%).
- 在60个月内,40.6%-44.3%的患者保持了持续的坚持.
- 早期停药的预测因素包括女性性别,大都市居住和LDL胆固醇升高.
结论:
- 超过一半的T2DM患者在五年内不持续使用药物.
- 不同的坚持轨迹需要量身定制的干预措施来支持持续治疗.
- 解决已识别的风险因素可以改善T2DM管理中的长期药物坚持.
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